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COVID-19 Update | June 11, 2021
Important Highlights
New OSHA Emergency Temporary Standard for Healthcare Settings 
The Occupational Safety and Health Administration (OSHA) issued an emergency temporary standard (ETS) on June 10 aimed at protecting workers in healthcare settings from COVID-19. OSHA also updated its COVID-19 guidance for employers and workers not covered by the new ETS. A detailed analysis can be found below in the Federal Policy Updates section. 
 
SLIDES: CDC Vaccines and Related Biological Products Advisory Committee (VRPBAC) June 10 meeting on vaccine safety. As of May 31, VAERS has received 475 reports of myocarditis or pericarditis among people 30 years of age and younger who received a COVID-19 vaccine. CDC and FDA have confirmed 226 reports meet CDC’s working case definition. Reports are rare, given the >18 million doses administered to people between ages 12-24 in the US. CDC continues to recommend COVID-19 vaccination for everyone 12 years and older.
SHEA Coronavirus News
SHEA Converse & Convene: Maintaining Focus on Other Healthcare Epidemiology Issues During COVID
(Open to SHEA Members)   
REGISTER HERE   
This members-only networking event will focus on questions related to working on other healthcare epi issues while focusing on COVID-19. Please note this event is not recorded and is intended for members to have an open, candid discussion around this topic.   
 
Moderator: Theresa Madaline, MD; NYC Health and Hospitals
Technical Guidance, Standards and Resources
Vaccines 
 
MMWRs 
Decreases in COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths Among Older Adults Following the Introduction of COVID-19 Vaccine — United States, September 6, 2020–May 1, 2021 (CDC MMWR)  
 
Decreases in COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths Among Older Adults Following the Introduction of COVID-19 Vaccine — United States, September 6, 2020–May 1, 2021 (CDC MMWR)  
 
Hospitalization of Adolescents Aged 12–17 Years with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, March 1, 2020–April 24, 2021 (CDC MMWR)  
 
Impact of Policy and Funding Decisions on COVID-19 Surveillance Operations and Case Reports — South Sudan, April 2020–February 2021 (CDC MMWR) 
 
COVID-19 Severity and COVID-19–Associated Deaths Among Hospitalized Patients with HIV Infection — Zambia, March–December 2020 (CDC MMWR)  
 
Infection Prevention and Control 
 
Long-Term Care 
COVID-19 in Nursing Homes: Most Homes Had Multiple Outbreaks and Weeks of Sustained Transmission from May 2020 through January 2021 (GAO) 
Clinical Care  
 
Incident Management 
 
Payment and Reimbursement Policy 
Research and Resources Development Funding Opportunities
Trade Press, Journal Articles, and White Papers
Underlying Medical Conditions Associated with Severe COVID-19 Illness Among Children  
Kompaniyets L, Agathis NT, Nelson JM, et al. JAMA Netw Open. 2021;4(6):e2111182. doi:10.1001/jamanetworkopen.2021.11182  
  
Differences between children with severe acute lower respiratory infection with or without SARS-CoV-2 infection 
Vivian Botelho Lorenzo, Cristiana Nascimento-Carvalho. Journal of Infection. Published: June 03,2021  
 
COVID-19 Vaccination of Health Care Personnel as a Condition of Employment: A Logical Addition to Institutional Safety Programs  
Talbot TR. JAMA. Published online June 07, 2021. doi:10.1001/jama.2021.8901
Federal Policy Updates
New OSHA Emergency Temporary Standard for Healthcare Settings 
The Occupational Safety and Health Administration (OSHA) issued an emergency temporary standard (ETS) aimed at protecting workers in healthcare settings from COVID-19. OSHA also updated its COVID-19 guidance for employers and workers not covered by the new ETS. The ETS is an interim final rule that will take effect immediately upon publication in the Federal Register. Employers must comply with most requirements within 14 days, and with other requirements relating to physical barriers, ventilation, and training within 30 days.  
 
The ETS applies only to employees in healthcare settings – specifically, hospitals, nursing homes, and assisted living facilities; emergency responders; home healthcare workers and employees in ambulatory care facilities where suspected or confirmed COVID-19 patients are treated.  There are some exceptions, outlined on pp. 1-3 of the public inspection copy (Subpart U). Exceptions include “well-defined hospital ambulatory care settings where all employees are fully vaccinated and all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not permitted to enter those settings”; “home healthcare settings where all employees are fully vaccinated and all non-employees are screened prior to entry and people with suspected or confirmed COVID-19 are not present”; among other settings. See flow chart to determine whether your workplace is covered by ETS.  
 
Employer Requirements – Beginning on p. 9, the ETS delineates key requirements. They include developing and implementing a COVID-19 plan that includes a designated safety coordinator, a workplace-specific hazard assessment, and policies and procedures to minimize the risk of transmission of COVID-19. See fact sheet for overview of all requirements. Additional requirements relate to: 
  • Patient screening and management (p.11) 
  • Standard and transmission-based precautions (p. 12)  
  • Personal protective equipment (PPE) (p. 13) 
  • Aerosol-generating procedures on a person with suspected or confirmed COVID-19 (p. 17) 
  • Physical distancing (p. 17) 
  • Physical barriers (p. 18) 
  • Cleaning and disinfection (p. 18) 
  • Ventilation (p. 18) 
  • Health screening and medical management (p. 20); 
  • Vaccination (p. 28): The ETS does not require employers to mandate COVID-19 vaccination, but it does require employers to provide employees with “reasonable time and paid leave” for vaccination and recovery from any side effects.  
  • Training (p. 28) 
  • Anti-retaliation (p. 30)
Beginning on p. 34, the ETS provides requirements for the mini respiratory protection program, which applies to circumstances when “when workers are not exposed to suspected or confirmed sources of COVID-19 but where respirator use could offer enhanced worker protection.” See fact sheet for details. The ETS requires employers with more than 10 employees to retain records, including a COVID-19 log to record COVID-19 cases in their workforce. See fact sheet for log requirements. It requires employers to report all work-related COVID-19 fatalities and in-patient hospitalizations to OSHA. See fact sheet for details. 
 
Comments are due 30 days after publication in the Federal Register. 
SHEA Education and Events
New this week:
  1. Podcast: COVID-19 in Children & the Pediatric Vaccine
  2. Town Hall Round 50:
    Sunday, June 27, 2021 | 3:00 pm ET 
    REGISTER HERE or watch live on Facebook
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